Spectrum Health Primary Care Partners
Organization Active NPI Pediatrics Physician · Grand Rapids, MI
NPI 1265734933 · NPPES record last updated Dec 1, 2010
Key facts
- NPI
- 1265734933
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pediatrics Physician 208000000X
- Legal business name
- SPECTRUM HEALTH PRIMARY CARE PARTNERS
- Practice address
- 330 Barclay Ave NE
Suite 303
Grand Rapids, MI 49503-2556 - Phone
- (616) 391-7999
- NPI assigned
- Dec 1, 2010
- Organization subpart
- Yes
- Parent organization (as reported)
- SPECTRUM HEALTH PRIMAY CARE PARTNERS
Authorized official
- Name
- Pauline Krywanski
- Title
- Cfo
- Phone
- (616) 486-2253
Corporate family (same tax ID) 24
National Provider Directory
- Tax ID family
- Spectrum Health Partners
- Part of
- Spectrum Health Partners
Locations
330 Barclay Ave NE
Ste 303
Grand Rapids, MI 49503
Phone (616) 391-1242
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician |
208000000X | Yes |
Addresses
Primary practice location
330 Barclay Ave NE
Suite 303
Grand Rapids, MI 49503-2556
Mailing address
100 Michigan St NE
Mc845
Grand Rapids, MI 49503-2560
Other providers in Grand Rapids, MI
- Spectrum Health Primary Care Partners
- Spectrum Health Primary Care Partners
- Spectrum Health Primary Care Partners
- Spectrum Health Primary Care Partners
- Spectrum Health Primary Care Partners
- Spectrum Health Primary Care Partners
- Spectrum Health Primary Care Partners
- Spectrum Health Primary Care Partners
- Spectrum Health Primary Care Partners
- Spectrum Health Primary Care Partners
All providers in Grand Rapids, MI · Pediatrics Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 1, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.